Age- and Sex-specific Prevalence, Longitudinal Trends and Factors of Cardiovascular-Kidney-Metabolic Syndrome Stages among Chinese Adults

Q: What are the key findings of this study?

Male sex was a strong risk factor for advanced Cardiovascular-Kidney-Metabolic syndrome (OR 2.22 to 23.22 across cohorts), with prevalence reaching 100% in male centenarians.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular-Kidney-Metabolic (CKM) syndrome (n=17470). Intervention: Male sex vs. Female sex. Primary outcome: Advanced CKM syndrome (stages 3-4) in the CHARLS cohort (OR 2.22, p=<0.05).

Q: What does this research mean for the field?

Male sex is a strong risk factor for advanced cardiovascular-kidney-metabolic syndrome in Chinese adults, with an age-related increase steeper in males and reaching 100% prevalence in male centenarians. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To assess age- and sex-standardized prevalence, longitudinal trajectories, and associated risk factors of cardiovascular-kidney-metabolic syndrome stages in Chinese adults, including centenarians.

Zhiyue Liang; Shiyuan Wei; Qi Gao; Shengli An; Licong Su

doi:10.1038/s41514-026-00428-z

June 16, 2026npj AgingOpen Access

Age- and Sex-specific Prevalence, Longitudinal Trends and Factors of Cardiovascular-Kidney-Metabolic Syndrome Stages among Chinese Adults

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Key result

Male sex linked to advanced CKM syndrome, reaching 100% prevalence in centenarians.

OR 2.22
P<0.05
n=17,470

Figures

Why the study?

Cardiovascular-Kidney-Metabolic syndrome remained uncharacterized in Chinese adults across ages, including centenarians.

Key Points

To assess age- and sex-standardized prevalence, longitudinal trajectories, and associated risk factors of cardiovascular-kidney-metabolic syndrome stages in Chinese adults, including centenarians.
Analyzed data from three Chinese cohorts: CHNS 2009 (n=6,604, age ≥30), CHARLS 2011 (n=9,077, age ≥45, with 8,069 followed in 2015), and CLHLS 2012 (n=1,789, age ≥65, with 1,035 followed in 2014).
Calculated age- and sex-standardized prevalence across CKM stages (0 to 4) and monitored short-term longitudinal changes in stage distribution.
Conducted multivariable logistic regression adjusted for age, sex, marital status, education, smoking, drinking, and BMI to detect factors linked to advanced CKM stages.
Standardized prevalence showed nearly 90% of adults at stage ≥1 and >18% with advanced CKM, with advanced stages reaching 64.7% in centenarians (n=345) and 100% in male centenarians (n=61).
Age, smoking, BMI, and male sex were independent risk factors for advanced CKM (CHARLS: OR=2.22; CHNS: OR=5.02; CLHLS: OR=23.22; all P<0.05), with significant age-by-sex interactions (all P<0.01).
Decomposition showed that over 99% of stage 3 cases were driven by cardiovascular disease risk alone (CHARLS 2011: 99.3% in females, 99.1% in males), whereas chronic kidney disease alone accounted for under 1%.

Study Design

Type

Cohort (n=17,470)

Multicenter

Yes

Structured PICO

P

Population

17,470 Chinese adults aged 30 and older from three national cohorts were assessed to determine the prevalence, longitudinal trends, and risk factors of Cardiovascular-Kidney-Metabolic syndrome.

O

Outcome

Age- and sex-standardized prevalence of Cardiovascular-Kidney-Metabolic (CKM) syndrome stages (0-4) and risk factors for advanced CKM (stages 3-4)

Main Result

Odds Ratio: 2.22

p-value: p=<0.05

The prevalence of Cardiovascular-Kidney-Metabolic (CKM) syndrome in Chinese adults is high and increases with age, with men experiencing significantly faster age-related progression to advanced stages.

Limitations

Potential selection bias due to missing data from some participants
Reliance on self-reported CVD definitions
Finite follow-up due to blood test availability
Small male centenarian sample size
Potential selection bias due to missing data

Implication

Suggests sex-specific CKM monitoring in aging Chinese adults; leaves open causal mechanisms and intervention effects.

Abstract

Cardiovascular-Kidney-Metabolic (CKM) syndrome is uncharacterized in Chinese adults across ages, including centenarians. From three cohorts, age- and sex-standardized CKM prevalence showed nearly 90% stage≥1 and >18% advanced. Prevalence rose with age; advanced CKM reached 100% in male centenarians. Age, sex, smoking, and BMI were risk factors for advanced CKM, with faster male progression. These findings highlight growing disease burden in China’s aging population and inform future CKM prevention.

Discussion

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Cite This Study

Liang et al. (2026) conducted a cohort in Cardiovascular-Kidney-Metabolic (CKM) syndrome (n=17,470). Male sex vs. Female sex was evaluated on Advanced CKM syndrome (stages 3-4) in the CHARLS cohort (OR 2.22, p=<0.05). Male sex was a strong risk factor for advanced Cardiovascular-Kidney-Metabolic syndrome (OR 2.22 to 23.22 across cohorts), with prevalence reaching 100% in male centenarians.

synapsesocial.com/papers/6a32623f8b0a6d04ea8e6a0e https://doi.org/10.1038/s41514-026-00428-z

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Age- and Sex-specific Prevalence, Longitudinal Trends and Factors of Cardiovascular-Kidney-Metabolic Syndrome Stages among Chinese Adults

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Age- and Sex-specific Prevalence, Longitudinal Trends and Factors of Cardiovascular-Kidney-Metabolic Syndrome Stages among Chinese Adults

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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